Uppercut Test
Original Editor - Matt Huey
Top Contributors - Matt Huey and Alexandra Stead
Introduction
The Uppercut test was developed to diagnose a lesion to the biceps tendon or a SLAP lesion. The original researchers based the performance of the test from the reports of patients with bicep injuries in which they stated it caused pain to perform a consistent motion of elbow flexion, forearm supination, and an upward, cross body motion, especially doing this motion against a resistance.[1]
Technique
This test is performed in the following manner:
- Have the patient make a fist with their hand, flex their elbow to 90 degrees and supinate their forearm (palm facing them)
- Ask the patient to bring their fist upward and across their body towards their chin (like an upper cut boxing motion)
- The examiner provides a resistance force to the patient's hand while performing this motion
A positive result is a pain or a pop in the front of the shoulder.
Research
Kibler et al.[1] compared this test to standard shoulder tests (Yergason's, Speed's, bear hug, belly press, O'Brien's, and anterior slide) for bicep and SLAP lesions. In looking at 325 individuals with shoulder pain when it came to detecting a biceps injury, the accuracy was found to be 77%, sensitivity 73% and specificity of 78%. For detecting a SLAP lesion, the accuracy was 32%, sensitivity 22% and specificity 32%.
Cardoso et al.[2] looked specifically at diagnosing lesions of the long head of the biceps. The uppercut test was compared to Speed's test, Yergason's, biceps resisted flexion and modified biceps resisted flexion test in 65 people scheduled for arthroscopic shoulder surgery. The tests did have a strict and loose interpretations meaning that if the test was inconclusive, with a strict interpretation the results were not counted as a positive. With the loose interpretation, the accuracy was found to be 70%, sensitivity 90%, and specificity 38% but with a strict interpretation the accuracy was 62%, sensitivity 61% and specificity 63%.
Rosas et al.[3] found the sensitivity increased to 88.4% and specificity of 93.8% when the uppercut was combined with the palpation of the biceps tendon test.
Resources
Evidence
- ↑ 1.0 1.1 Ben Kibler W, Sciascia AD, Hester P, Dome D, Jacobs C. Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder. Am J Sports Med. 2009;37(9):1840-1847
- ↑ Cardoso, A., Amaro, P., Barbosa, L., Coelho, A. M., Alonso, R., & Pires, L. (2019). Diagnostic accuracy of clinical tests directed to the long head of biceps tendon in a surgical population: a combination of old and new tests. Journal of Shoulder and Elbow Surgery, 28(12), 2272-2278.
- ↑ Rosas, S., Krill, M. K., Amoo-Achampong, K., Kwon, K., Nwachukwu, B. U., & McCormick, F. (2017). A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps. Journal of shoulder and elbow surgery, 26(8), 1484-1492.